Basic Information
Provider Information
NPI: 1952806135
EntityType: 2
ReplacementNPI:  
OrganizationName: UNC ROCKINGHAM HEALTH CARE, INC.
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
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Credential:  
OtherOrganizationName: UNC ROCKINGHAM WOMEN'S HEALTH CENTRE
OtherOrganizationType: 3
OtherLastName:  
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Mailing Information
Address1: 211 FRIDAY CENTER DR STE 2057
Address2:  
City: CHAPEL HILL
State: NC
PostalCode: 275179499
CountryCode: US
TelephoneNumber: 9849741281
FaxNumber:  
Practice Location
Address1: 522 S VAN BUREN RD
Address2:  
City: EDEN
State: NC
PostalCode: 272885019
CountryCode: US
TelephoneNumber: 3366271117
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/28/2018
LastUpdateDate: 03/28/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: WAGSTAFF
AuthorizedOfficialFirstName: HUNTER
AuthorizedOfficialMiddleName: WALTER
AuthorizedOfficialTitleorPosition: TREASURER
AuthorizedOfficialTelephone: 9849741266
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X  Y193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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